National Provider Identifier [NPI]: |
1962842179 |
Last Name Of The Provider |
SINCLAIR |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
806 W DIAMOND AVE |
Street Address 2 Of The Provider |
# 110 |
City Of The Provider |
GAITHERSBURG |
Zip Code Of The Provider |
208781415 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
575 |
Number Of Medicare Beneficiaries |
343 |
Total Submitted Charge Amount |
57725 |
Total Medicare Allowed Amount |
28307.37 |
Total Medicare Payment Amount |
20053.55 |
Total Medicare Standardized Payment Amount |
23664.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
29 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
401 |
Total Drug Medicare AllowedAmount |
31.77 |
Total Drug Medicare PaymentAmount |
27.25 |
Total Drug Medicare Standardized Payment Amount |
27.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
546 |
Number Of Medicare Beneficiaries With Medical Services |
343 |
Total Medical Submitted Charge Amount |
57324 |
Total Medical Medicare Allowed Amount |
28275.6 |
Total Medical Medicare Payment Amount |
20026.3 |
Total Medical Medicare Standardized Payment Amount |
23637.04 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
159 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
229 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
244 |
Number Of Black or African American Beneficiaries |
80 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
240 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0158 |